Calciphylaxis in chronic, non-dialysis-dependent renal disease

• Main Authors: Paschke Ralf, Schwock Jörg, Pliquett Rainer U, Achenbach Harald
• Format: Article
• Language: English
• Published: BMC 2003-09-01
• Series: BMC Nephrology
• Online Access: http://www.biomedcentral.com/1471-2369/4/8

<p>Abstract</p> <p>Background</p> <p>Calciphylaxis cutis is characterized by media calcification of arteries and, most prominently, of cutaneous and subcutaneous arterioles occurring in renal insufficiency patients.</p> <p>Case Report</p> <p>A 53-year-old woman with chronic cardiac and renal failure complained of painful crural, non-varicosis ulcers. She was hospitalized in an immobilized condition due to both the crural ulcerations and the existing heart-failure state (NYHA III-IV) having pleural and pericardial effusions, atrial fibrillation and weight loss of 30 kg over the past year. Despite normalization of calcium-phosphorus balance and improvement of renal function, the clinical course of crural ulcerations deteriorated during the following 3 months. After failure of surgical debridements, multiple courses of sterile-maggot therapy were introduced at a late stage to stabilize the wounds. The patient died of recurrent wound infections and sepsis paralleled by exacerbations of renal malfunction.</p> <p>Conclusions</p> <p>The role of renal disease in vascular complications is discussed. Sterile-maggot debridement may constitute a therapy for the ulcerated calciphylaxis at an earlier stage, i.e. when first ulcerations appear.</p>